Referrals Specialist

    • Job Tracking ID: 512365-428710
    • Job Location: Petaluma, CA
    • Job Level: Entry Level (less than 2 years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: September 04, 2019
    • Years of Experience: Less Than 1 Year
    • Starting Date: July 25, 2019
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Job Description:

COME JOIN OUR TEAM! This multi-faceted entry level position is directly responsible for providing excellent patient care and customer service! As a referrals specialist you will work to ensure that a patient's insurance allows them to access specialty services requested by their provider. You will sit in a back office setting while you work as part of a small specialized team reporting to the Clinical Operations & Referrals Manager. This dynamic role requires someone who can work efficiently, multi-task, stay calm under pressure, and be willing to be part of the positive experience every patient experiences at the Petaluma Health Center.

 

What We Will Bring to the Table:

  • Extremely competitive benefits including: Health, Dental, and Vision coverage
  • A highly energetic and fast paced environment at a growing healthcare clinic
  • Chiropractic/Acupuncture
  • 401(k)
  • Generous paid time off
  • Life Insurance
  • Supplemental Benefit options
  • EAP
  • Fitness Club Membership discounts

Areas of Responsibility:

Patient Care:

  • Verification of patient insurance eligibility.
  • Maintains updated authorizations/referrals information in patient chart through a tracking mechanism. 
  • Provides assistance to uninsured patients to be enrolled in PAP program. 
  • Provides information to patient through warm hand offs as needed.

 Customer Service:

  • Makes and/or answers phone calls regarding any referral questions.
  • Assist patients in the appeals process for denial of services through the proper appeals process with their insurance companies.
  • Maintain extensive resource directory for PHC staff and patients for access of community resources.

Referral Tracking:

  • Process all outside referrals from other PCP/specialist within expected timeframe. 
  • Closes 20 referrals daily. 
  • Tracks the completion of the referral process within expected timeframe.
  • Track referrals by using structured data to maintain up to date accurate information. 
  • Ensures follow up with Public Health Nurse for CHDP Referrals made. 
  • Knowledge of managed care requirements for referrals. 
  • Participates in MAA Coordination and Claims Administration, including but not limited to completion of the annual time survey.
  • Perform other duties as assigned by Referrals and Specialty Clinics Operations Manager or Director of Clinical Operations

Experience and Skills:

What We're Looking For: 

  • Strong analytical and problem-solving skills
  • Able to meet deadlines by having effective time management and communication skills 
  • Ability to effectively present information and respond to questions from groups of patients, physicians and other medical personnel concerning referral resources for various payers.
  • Excellent organizational skills with attention to detail, multi-tasking and the ability to prioritize tasks and needs of patients and providers. 

Education/Experience

  • High school graduate with medical office training.
  • Two years experience with insurance, referrals, authorizations, and community contacts.

 

 Language Skills

Ability to communicate effectively in English and Spanish with children and adults in person, on the telephone, and in writing. Ability to effectively present information and respond to questions and requests from patients, co-workers and others as necessary.